CMS-1500 Box 24J / 33a • NPI
1477946820
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
213EP1101X (CMS 48)
Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine
Box 32 Service Location & ZIP+4
13500 SUTTON PARK DR S, SUITE 403, JACKSONVILLE, FL, 32224-5251
✓ 9-Digit EDI 837 ZIP+4 (32224-5251)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1477946820 (ADVANCED WOUND CARE OF NORTH FLORIDA, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1477946820 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVANCED WOUND CARE OF NORTH FLORIDA, LLC |
| Plain-English Specialty | Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine NUCC Code: 213EP1101X (Podiatrist, Primary Podiatric Medicine) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 13500 SUTTON PARK DR S, SUITE 403, JACKSONVILLE, FL, 32224-5251 |
| Practice Telephone / Fax | Tel: (904) 493-3390 | Fax: (904) 493-3395 |
| Administrative Mailing Address | 108 PRINCE PHILLIP DR, ST AUGUSTINE, FL, 32092-1746 |
| Enumeration & Last Sync | Enumerated: 2015-03-10 | CMS Record Updated: 2015-03-10 |
| Authorized Official | JOHN LAGOUTARIS (Owner) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (213EP1101X)
What Does Taxonomy Code 213EP1101X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 213EP1101X translates to:
"Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVANCED WOUND CARE OF NORTH FLORIDA, LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
213ES0103X — Podiatrist, Foot & Ankle SurgeryPlain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot & Ankle Surgery | State: FL | License: PO3240 | Primary: Secondary |
213ES0131X — Plain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Foot Surgery | State: FL | License: PO3240 | Primary: Secondary |
213EP1101X — Podiatrist, Primary Podiatric MedicinePlain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine | State: FL | License: PO3240 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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